Wednesday, August 11, 2010

NewFNP would be absolutely fine to stay on CME, take hikes through beautiful mountain trails, reconnect with good pals from grad school, drink White Russians and play Quiddler.

For those who are interested, newFNP posted her notes from a very helpful EKG interpretation lecture on the newFNPFacebook page. The response has been quick and somewhat shocking. How is it that so many new nurse practitioners feel like their EKG education was utter shit? NewFNP certainly did. One reason might be that the lecture newFNP attended was one that is normally given to medical residents. What the fuck, expensive brand-name nurse practitioner school from which newFNP is a proud alum? Your students don't deserve as good an education? Lame. Apparently, there is a nationwhide epidemic of poorly taught EKG interpretation in NP schools. Super lame.

NewFNP maintains that NP education needs a bit of a re-vamp. A little more specialty exposure that is highly relevant to primary care -- like dermatology, neurology, endocrinology and cardiology -- is in order. Seriously, when so many NPs are planning to work in community health where access to specialty care is nearly non-existent, throw your students (and their future patients) a bone. And then give NPs a residency. It doesn't have to be three years, but even a year or eighteen months would go a long way in helping newly minted NPs be more ready to care for patients.

Sadly, it's unlikely that newFNP will ever be in a position to transform nursing education. Yet with all the NPs in this country and in school currently, she wonders just how in the hell is it that it hasn't been done yet?

I would, gladly, have traded all the hours wasted on nursing theory for a good derm course, or EKG interpretation course, or GI stuff, or birth control methods - ANYTHING that would have actually helped me and my patients in real life practice.

There needs to be more clinical education rather than theory. I would have used my clinical time learning more of what I really needed to know. I didn't get enough EKG instruction either. If there was a program for a DNP that didn't require ANOTHER research project, I would do it.

Of course, the prob is that the first people the DNP is being marketed to are current NPs, who can get this stuff from current jobs and/or CMEs. So they needed to come up with stuff we don't get otherwise. Enter: health care finance, epi, informatics, etc etc etc.

Do I, as a working NP, feel like I need to complete a residency? Hell no! Sure, my first job essentially acted as a residency (but with better pay) and if I'd had the opportunity to complete one as a new grad I would have taken it, but I'd have less than 0 interest in a MSN to DNP program that included a required residency.

Which is why the entry DNP programs really need to be fundamentally different than these DNP-for-already-NPs programs. But that doesn't make for as tidy a sell. Sigh.

i agree. i am a student np at one of the top nursing schools in the country, just did a physical exam and diagnosis course,and i cannot believe just how little i really took away. i am in the psych np track, but the future fnps in the program got the same education as me this quarter. it is hard to believe how much it is lacking.thanks for the blog!

Apparently other NPs understand how mortifying it is to realize on your first day of practice you were never even taught how to interpret a UA

In hindsight, I find it horribly ironic that while my NP professors were lobbying state government for more independent practice, they neglected to teach the skills needed for this! Example: today we will learn everything about chest x-rays in 30 minutes and never discuss again. BTW, the discussion is led BY ONE OF YOUR CLASSMATES

On the plus side, I own an impressive set of research texts my husband uses for counterweights in his workshop

I am in the first class of BSN to DNP program at my university right now. Throughout my nursing education, I always wished we would dig a little deeper and focus a little more on the "why" of things. Also, as mean as some recent publications of the AMA have been, they make a point that maybe we should all have a little primary care basis before we specialize. And, I don't know, have the same organizations certify us? I am currently going into Women's Health, and am drawing heavily upon my med/surg experience for the primary care side of things.

Glad to see I'm not the only one who feels somewhat cheated by her education! My expectations about what I was going to learn and experience, and what I actually experienced were DRASTICALLY different! I had horrible clinical rotations. I learned very little. I was basically thrown wherever I could get in. We had to help find our own clinical sites and often these sites weren't useful.

This blog is for new NPs or NP students who want some real 411 on the life of a new practitioner. A new practitioner in a busy, understaffed, urban community health clinic in a major metropolitan area. Oh, and newFNP swears while writing and, sometimes, while working although she tries to keep those swears to herself. Consider yourself warned.